In their own words : adolescents strategies to prevent friend's risk taking

Injury is a significant public health problem among youth. A primary cause of adolescent injury is risk-taking behavior, including alcohol use, interpersonal violence and road-related risks. A novel approach to prevention is building on friendships by encouraging adolescents to intervene into their friends’ risk taking. Fifty-one early adolescents (13-14 years) and 44 older adolescents (16-17 years) from two Australian schools participated in focus groups, aiming to explore stories of intervening. Findings showed preference for talking to friends; however, participants also spoke to adults, monitored friends’ behavior and planned ahead. Close friendships, perceived harm, and self-efficacy influenced the likelihood of intervening. These findings have implications for the design of risk and injury prevention programs, by suggesting strategies to promote adolescents’ communicative ability for risk reduction. The findings also highlight the language and dialogue of adolescents and suggest that methods for increasing intervening behavior should focus on building social connectedness and increasing self-efficacy.

Rethinking disaster risk management and climate change adaptation

Australian governments face the twin challenges of dealing with extreme weather-related disasters (such as floods and bushfires) and adapting to the impacts of climate change. These challenges are connected, so any response would benefit from a more integrated approach across and between the different levels of government.This report summarises the findings of an NCCARF-funded project that addresses this problem. The project undertook a three-way comparative case study of the 2009 Victorian bushfires, the 2011 Perth Hills bushfires, and the 2011 Brisbane floods. It collected data from the official inquiry reports into each of these events, and conducted new interviews and workshops with key stakeholders. The findings of this project included recommendations that range from the conceptual to the practical. First, it was argued that a reconceptualization of terms such as ‘community’ and ‘resilience’ was necessary to allow for more tailored responses to varying circumstances. Second, it was suggested that the high level of uncertainty inherent in disaster risk management and climate change adaptation requires a more iterative approach to policymaking and planning. Third, some specific institutional reforms were proposed that included: 1) a new funding mechanism that would encourage collaboration between and across different levels of government, as well as promoting partnerships with business and the community; 2) improving community engagement through new resilience grants run by local councils; 3) embedding climate change researchers within disaster risk management agencies to promote institutional learning, and; 4) creating an inter-agency network that encourages collaboration between organisations.

The impact of risk-reducing hysterectomy and bilateral salpingo-oophorectomy on survival in patients with a history of breast cancer – a population-based data linkage study

Prophylactic surgery including hysterectomy and bilateral salpingo-oophorectomy (BSO) is recommended in BRCA positive women, while in women from the general population, hysterectomy plus BSO may increase the risk of overall mortality. The effect of hysterectomy plus BSO on women previously diagnosed with breast cancer is unknown. We used data from a population-base data linkage study of all women diagnosed with primary breast cancer in Queensland, Australia between 1997 and 2008 (n=21,067). We fitted flexible parametric breast cancer specific and overall survival models with 95% confidence intervals (also known as Royston-Parmar models) to assess the impact of risk-reducing surgery (removal of uterus, one or both ovaries). We also stratified analyses by age 20-49 and 50-79 years, respectively. Overall, 1,426 women (7%) underwent risk-reducing surgery (13% of premenopausal women and 3% of postmenopausal women). No women who had risk-reducing surgery, compared to 171 who did not have risk-reducing surgery developed a gynaecological cancer. Overall, 3,165 (15%) women died, including 2,195 (10%) from breast cancer. Hysterectomy plus BSO was associated with significantly reduced risk of death overall (adjusted HR = 0.69, 95% CI 0.53-0.89; P =0.005). Risk reduction was greater among premenopausal women, whose risk of death halved (HR, 0.45; 95% CI, 0.25-0.79; P < 0.006). This was largely driven by reduction in breast cancer-specific mortality (HR, 0.43; 95% CI, 0.24-0.79; P < 0.006). This population-based study found that risk-reducing surgery halved the mortality risk for premenopausal breast cancer patients. Replication of our results in independent cohorts, and subsequently randomised trials are needed to confirm these findings.

Community engagement for disaster resilience : flood risk management in Jakarta, Indonesia

Understanding dynamics of interactions between community groups and government agencies is crucial to improve community resilience for flood risk reduction through effective community engagement strategies. Overall, a variety of approaches are available, however they are limited in their application. Based on research of a case study in Kampung Melayu Village in Jakarta, further complexity in engaging community emerges in planning policy which requires the relocation of households living in floodplains. This complexity arises in decision-making processes due to barriers to communication. This obstacle highlights the need for a simplified approach for an effective flood risk management which will be further explored in this paper. Qualitative analyses will be undertaken following semi-structured interviews conducted with key actors within government agencies, non-governmental organisations (NGOs), and representatives of communities. The analyses involve investigation of barriers and constraints on community engagement in flood risk management, particularly relevant to collaboration mechanism, perception of risk, and technical literacy to flood risk. These analyses result in potential redirection of community consultation strategies to lead to a more effective collaboration among stakeholders in the decision-making processes. As a result, greater effectiveness in plan implementation of flood risk management potentially improves disaster resilience in the future.

The role of timber plantations in UK Investment portfolios

Although timber plantations and forests are classified as forms of agricultural production, the ownership of this land classification is not limited to rural producers. Timber plantations and forests are now regarded as a long-term investment with both institutional and absentee owners. While the NCREIF property indices have been the benchmarks for the measurement of the performance of the commercial property market in the UK, for many years the IPD timberland index has recently emerged as the U.K. forest and timberland performance indicator. The IPD Forest index incorporates 126 properties over five regions in the U.K. This paper will utilise the IPD Forestry Index to examine the performance of U.K. timber plantations and forests over the period 1981-2004. In particular, issues to be critically assessed include plantation and forest performance analysis, comparative investment analysis, and the role of plantations and forests in investment portfolios, the risk reduction and portfolio benefits of plantations and forests in mixed-asset portfolios and the strategic investment significance of U.K. timberlands.

An Analysis of UK Farmland : 1981-2004

The importance of agriculture in many countries has tended to reduce as their economies move from a resource base to a manufacturing industry base. Although the level of agricultural production in first world countries has increased over the past two decades, this increase has generally been at a less significant rate compared to other sectors of the economies. Despite this increase in secondary and high technology industries, developed countries have continued to encourage and support their agricultural industries. This support has been through both tariffs and price support. Although the average farm production property may require this support to maintain long-term production, the better farms can actually achieve production levels and commodity prices that result in these units being competitive on a free market basis. This paper will analyse the total return performance of UK farmland over the period 1981-2004. This analysis will compare the total return from rural properties in the UK and compare this performance to commercial property returns (total, office, retail, industrial), equities and gilts over this 24-year period. The analysis will be based on the IPD UK let land index and the IPD property index. The portfolio diversification and risk-reduction benefits of UK farmland will be highlighted. The analysis shows that rural property has negative correlations with equities and gilts, as well as insignificant positive correlations with retail, industrial and office property. Rural property also provides portfolio diversification benefits.

The role of timber plantations in U.K. investment portfolios

Although timber plantations and forests are classified as forms of agricultural production, the ownership of this land classification is not limited to rural producers. Timber plantations and forests are now regarded as a long-term investment with both institutional and absentee owners. While the NCREIF property indices have been the benchmarks for the measurement of the performance of the commercial property market in the UK, for many years the IPD timberland index has recently emerged as the U.K. forest and timberland performance indicator. The IPD Forest index incorporates 126 properties over five regions in the U.K. This paper will utilise the IPD Forestry Index to examine the performance of U.K. timber plantations and forests over the period 1981-2004. In particular, issues to be critically assessed include plantation and forest performance analysis, comparative investment analysis, and the role of plantations and forests in investment portfolios, the risk reduction and portfolio benefits of plantations and forests in mixed-asset portfolios and the strategic investment significance of U.K. timberlands.

Role of timberland in us investment portfolios

Timberland is now regarded as a long-term investment with both institutional investors and absentee owners. This paper utilises the NCREIF Timberland index to examine the performance of US timberland over the period of 1987-1999. US timberland was found to provide significant risk reduction and portfolio diversification benefits in the portfolio resulting from the low risk and low correlation with stocks and bonds. Timberland was also found to make a significant contribution to a portfolio of stocks, bonds and real estate, particularly at low to midrange portfolio risk levels.

Role of farm real estate in a globally diversified asset portfolio

Purpose - The paper examines the benefits of further diversifying a global portfolio of financial assets with New Zealand farm real estate (FRE). ---------- Design/methodology/approach - We compare efficient sets generated with and without farm real estate using portfolio theory. ---------- Findings - The results show that given the predominantly negative correlation between FRE and financial assets, the risk-return tradeoffs of portfolios of financial assets can be improved significantly. The diversification benefits measured in terms of risk reduction, return enhancement, and improvement in the Sharpe performance ratios are robust under a number of FRE risk-return scenarios as well as under high and low inflationary periods. Using 5- and 10-year rolling periods we also find that FRE is a consistent part of risk efficient portfolios. Consistent with the results reported in Lee and Stevenson (2006) for UK real estate the risk reduction benefits of diversifying with FRE are larger than the risk enhancement benefits. ---------- Practical implication - The results suggest that FRE takes on a consistent role of risk-reducer rather than a return-enhancer in a globally diversified portfolio. FRE appears to deserve more serious consideration by investment practitioners that it has been accorded in the past. Originality/value – The study examines the role of direct real estate in a globally diversified portfolio of financial assets.

Patient preference for falls prevention in hospitals revealed through willingness-to-pay, contingent valuation survey

Rationale, aims and objectives: Patient preference for interventions aimed at preventing in-hospital falls has not previously been investigated. This study aims to contrast the amount patients are willing to pay to prevent falls through six intervention approaches. ----- ----- Methods: This was a cross-sectional willingness-to-pay (WTP), contingent valuation survey conducted among hospital inpatients (n = 125) during their first week on a geriatric rehabilitation unit in Queensland, Australia. Contingent valuation scenarios were constructed for six falls prevention interventions: a falls consultation, an exercise programme, a face-to-face education programme, a booklet and video education programme, hip protectors and a targeted, multifactorial intervention programme. The benefit to participants in terms of reduction in risk of falls was held constant (30% risk reduction) within each scenario. ----- ----- Results: Participants valued the targeted, multifactorial intervention programme the highest [mean WTP (95% CI): $(AUD)268 ($240, $296)], followed by the falls consultation [$215 ($196, $234)], exercise [$174 ($156, $191)], face-to-face education [$164 ($146, $182)], hip protector [$74 ($62, $87)] and booklet and video education interventions [$68 ($57, $80)]. A ‘cost of provision’ bias was identified, which adversely affected the valuation of the booklet and video education intervention. ----- ----- Conclusion: There may be considerable indirect and intangible costs associated with interventions to prevent falls in hospitals that can substantially affect patient preferences. These costs could substantially influence the ability of these interventions to generate a net benefit in a cost–benefit analysis.

Post-disaster housing reconstruction : challenges for community participation

The extant literature suggests that community participation is an important ingredient for the successful delivery of post-disaster housing reconstruction projects. Even though policy-makers, international funding bodies and non-governmental organisations broadly appreciate the value of community participation, post-disaster reconstruction practices systematically fail to follow, or align with, existing policy statements. Research into past experiences has led many authors to argue that post-disaster reconstruction is the least successful physically visible arena of international cooperation. Why is the principle of community participation not evident in the veracity of reconstructions already carried out on the ground? This paper discusses and develops the concepts of, and challenges to, community participation and the subsequent negative and positive effects on post-disaster reconstruction projects outcomes.

Assessing the resilience of potable water supplies in Southeast Queensland Australia

Historically, cities as urban forms have been critical to human development. In 1950, 30% of the world’s population lived in major cities. By the year 2000 this had increased to 47% with further expected growth to 50% by the end of 2007. Projections suggest that city-based densities will edge towards 60% of the global total by 2030. Such rapidly increasing urbanisation, in both developed and developing economies, challenges options for governance and planning, as well as crisis and disaster management. A common issue to the livability of cities as urban forms through time has been access to clean and reliable water supply. This is an issue that is particularly important in countries with arid ecosystems, such as Australia. This paper examines preliminary aspects, and theoretical basis, of a study into the resilience of the (potable) water supply system in Southeast Queensland (SEQ), an area with one of the most significant urban growth rates in Australia. The first stage will be to assess needs and requirements for gauging resilience characteristics of a generic water supply system, consisting of supply catchment, storage reservoir/s and treatment plant/s. The second stage will extend the analysis to examine the resilience of the SEQ water supply system incorporating specific characteristics of the SEQ water grid made increasingly vulnerable due to climate variability and projected impacts on rainfall characteristics and compounded by increasing demands due to population growth. Longer-term findings will inform decision making based on the application of the concept of resilience to designing and operating stand-alone and networked water supply infrastructure systems as well as its application to water resource systems more generally.

Driving for work : a series of organisational audit results

Previous research has indicated that road crashes are the most common form of work related fatalities (Haworth et al., 2000). Historically, industry has often taken a “silver bullet” approach developing and implementing a single countermeasure to address all their work related road safety issues, despite legislative requirements to discharge obligations through minimising risk and enhancing safety. This paper describes the results and implications from a series of work related road safety audits that were undertaken across five organisations to determine deficiencies in each organisation‟s safe driving management and practice. Researchers conducted a series of structured interviews, reviewed documentation relating to work related driving, and analysed vehicle related crash and incident records to determine each organisation‟s current situation in the management of work related road safety and driver behaviour. A number of consistent themes and issues across each organisation were identified relating to managing driver behaviour, organisational policies, incident recording and reporting, communication and education, and formalisation of key work related road safety strategies. Although organisations are required to undertake risk reduction strategies for all work related driving, the results of the research suggest that many organisations fail to systematically manage driver behaviour and mitigate work related road safety risk. Future improvements in work related road safety will require organisations to firstly acknowledge the high risk associated with drivers driving for work and secondly adopt comprehensive risk mitigation strategies in a similar manner to managing other workplace hazards.

Falls after discharge from hospital : is there a gap between older peoples' knowledge about falls prevention strategies and the research evidence?

Purpose: The aim of this study was to examine whether older people are prepared to engage in appropriate falls prevention strategies after discharge from hospital. Design and Methods We used a semi-structured interview to survey older patients about to be discharged from hospital and examined their knowledge regarding falls prevention strategies to utilize in the post-discharge period. The study was part of a prospective cohort study, nested within a larger, randomized controlled trial. Participants (n = 333) were asked to suggest strategies to reduce their falls risk at home after discharge, and their responses were compared with current reported research evidence for falls prevention interventions.  Results Participants’ strategies (n = 629) were classified into 7 categories: behavioral, support while mobilizing, approach to movement, physical environment, visual, medical, and activities or exercise. Although exercise has been identified as an effective falls risk reduction strategy, only 2.9% of participants suggested engaging in exercises. Falls prevention was most often conceptualized by participants as requiring 1 (35.4%) or 2 (40.8%) strategies for avoiding an accidental event, rather than engaging in sustained multiple risk reduction behaviors.  Implications Results demonstrate that older patients have low levels of knowledge about appropriate falls prevention strategies that could be used after discharge in spite of their increased falls risk during this period. Findings suggest that health care workers should design and deliver falls prevention education programs specifically targeted to older people who are to be discharged from hospital.

Factors influencing health behaviours of younger women after menopause-inducing cancer treatment

Objective To investigate the health promotion and risk reduction behaviors of younger women previously treated for cancer. Design and Sample Guided by the Precede-Proceed framework, a mixed-method descriptive investigation of the health behaviors of younger women with cancer treatment-induced menopause in one health jurisdiction in Australia was undertaken. Measures This article reports the results of the qualitative interview component of the study. Results Of the 85 women who responded to surveys that quantified their health behaviors, 22 consented to interviews that explored how and why these behaviors might occur. Conclusions Several predisposing, enabling and reinforcing factors that influenced participants will or ability to engage with health-promoting behaviors after cancer treatment were identified in the interviews. These include entrenched precancer diagnosis health behaviors, the disabilities resulting from cancer treatments, perceptions of risk, focused intervention by health professionals and the nature of participants social support. The results indicate a need for flexibility when planning public health initiatives to prepare this cohort for a healthy life after cancer, which accounts for their developmental, knowledge and posttreatment needs.